Sunday, March 16, 2008

ECONOMIC MALPRACTICE

The New York Times published a story on the front page of Sunday’s paper about a drug used to treat Gaucher’s disease. The drug is a enzyme replacement for the inherited deficiency in glucocerebrocidase. I was not even aware that the disease can present initially in adulthood. I’ve never seen a patient with it. Not surprising, since only about 20,000 individuals in the United States have ti (according to UpToDate).

The drug in question, Cerezyme, is made by the Genzyme company. As the Times’ Andrew Pollack reports:

“Sales of Cerezyme totaled $1.1 billion last year, making it a blockbuster by industry standards.”

Yeah, I’d say that’s a blockbuster by industry standards. Or ANY freaking standards. Of course, any drug rep whoring for Pfizer will tell you, it’s the R AND D costs that make these drugs so expensive. The article goes on to say:

“But critics say the company’s development costs were minimal, because the early work on the treatment was done by the National Institutes of Health, which gave Genzyme a contract to manufacture it. And analysts estimate the current cost of manufacturing the drug to be only about 10 percent of its price.”

When the government hands out these “contracts” to private companies, they don’t seem to care too much about the general public, do they.

Now, I’m all for businesses making a profit. I’m no socialist. However, just as the public (and the government) have decided that doctors should not be aloowed to make too much money, so they (and the government) should not allow ANY healthcare providing entity to make any amount of money they want. This goes for Big Pharma, for medical equipment companies, for medical insurance companies, etc. etc. Since physicians are supposed to be putting patients first, why the HELL aren’t these other companies forced to do the same? It’s not as if they have different customers than doctors do. It’s not as if they are getting the money from a different place than doctors are.

And another thing, if this drug is costing insurers 1.1 billion dollars a year (and I’m assuming none of that is being paid for out of pocket by patients), then how can doctors be primarily to blame for rising healthcare costs? I don’t cost anywhere NEAR that much. Think how much money could have been saved if the United States had just set up the drug manufacturing for Cerezyme by itself. No profit would have been sought. The drug would probably be like 100 bucks a shot.

BUT NO!!! Let’s cut reimbursement to all Primary Care doctors, so we can heap billions of dollars for a drug that treats a few thousand people. Makes perfect sense. In CRAZYLAND!!!